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1.
Neurol India ; 70(5): 1901-1904, 2022.
Article in English | MEDLINE | ID: covidwho-2116688

ABSTRACT

Background: Coronavirus is a novel virus which has disrupted life in the past year. While it involves the lungs in the majority and this has been extensively studied, it involves other organ systems. More number of studies need to be focused on the extrapulmonary manifestations of the disease. Objective: To delineate the clinical manifestations of coronavirus disease 2019 (COVID-19) virus on the central and peripheral nervous systems and to assess the risk factors and the outcome of COVID-19 patients with neurological manifestations. Materials and Methods: All patients who were SARS-CoV-2 RNA polymerase chain reaction (PCR) positive were assessed, and detailed clinical history and laboratory findings were collected. Data was analyzed using percentage, mean, and frequency. Results: Out of 864 patients, 17 (N = 17, 1.96%) had neurological manifestations. Twelve out of 17 had comorbid conditions. Patients had diverse presentations ranging from acute cerebrovascular accident to paraplegia and encephalopathy. Ten (58.8%) patients presented with acute cerebrovascular accidents. Of the patients who developed stroke, five (50%) died. Conclusions: COVID-19 usually presents as a respiratory disease. The neurological manifestations of COVID-19 are not uncommon. One should be aware of a wide spectrum of neurological signs and symptoms of COVID-19 for early diagnosis and treatment for preventing mortality and morbidity.


Subject(s)
COVID-19 , Nervous System Diseases , Stroke , Humans , COVID-19/complications , SARS-CoV-2 , RNA, Viral , Tertiary Care Centers , Nervous System Diseases/epidemiology , Nervous System Diseases/etiology
2.
3.
Zh Nevrol Psikhiatr Im S S Korsakova ; 122(10): 31-37, 2022.
Article in Russian | MEDLINE | ID: covidwho-2091095

ABSTRACT

The consequences of COVID-19 include a wide range of neurological, emotional and cognitive impairments. The pathogenesis of postcovid disorders is complex and has not been fully studied. The article discusses the pathogenesis and clinical manifestations of neuropostocoid. A hypothesis is formulated about the possible role of circumventricular organs in its formation. The main directions of treatment of patients with postcovid disorders are proposed.


Subject(s)
COVID-19 , Cognitive Dysfunction , Nervous System Diseases , Humans , Intercellular Signaling Peptides and Proteins/therapeutic use , Peptides/therapeutic use , COVID-19/complications , Nervous System Diseases/etiology , Nervous System Diseases/drug therapy , Cognitive Dysfunction/drug therapy
4.
Zh Nevrol Psikhiatr Im S S Korsakova ; 122(9): 22-28, 2022.
Article in Russian | MEDLINE | ID: covidwho-2056580

ABSTRACT

During the pandemic caused by SARS-CoV-2, the ability of this virus to infect the structures of the peripheral and central nervous system becomes increasingly clear. Damage to the nervous system is noted in almost 85% of patients who have had COVID-19, both those who have had this disease in severe form, and in patients with mild or asymptomatic course. COVID-19 worsens symptoms in patients with Parkinson's disease (PD), which potentially increases the risk of death due to pneumonia and respiratory disorders in patients with severe stages of PD. There is a concern that the COVID-19 pandemic may lead to a sharp increase in the incidence of parkinsonism, while the ability of the SARS-CoV-2 virus to cause PD is assumed. The following ways of virus penetration, including the SARS-CoV-2 virus, into the structures of the central nervous system are considered - viremia and endothelial cell damage, as well as retrograde axonal transport. The direct penetration of the COVID-19 virus into the structures of the brain may be due to a disturbance of the blood-brain barrier due to a «cytokine storm¼ and activation of lymphocytes, which is due to the processes of neuroinflammation. According to some of its manifestations, the extrapyramidal syndrome observed in patients with COVID-19 resembles lethargic encephalitis von Economo. However, the question of the possibility of COVID-19 causing the development of PD is extremely complex and ambiguous. The latency period between viral encephalitis and the onset of parkinsonism can reach 5 years. It is possible that the basis for the development of neurological disorders, including parkinsonism, in this category of patients is an energy deficit that leads to disruption of the functioning of neural networks (human connectome) of the human brain. Based on the currently very limited data concerning the penetration of the COVID-19 virus into the structures of the central nervous system, there is no convincing evidence of this virus causing parkinsonism. The final clarity on this issue will be provided by the results of observations on the condition of patients who have undergone COVID-19.


Subject(s)
COVID-19 , Nervous System Diseases , Parkinsonian Disorders , COVID-19/epidemiology , Cytokines , Humans , Nervous System Diseases/etiology , Pandemics , Parkinsonian Disorders/epidemiology , SARS-CoV-2
5.
Medicine (Baltimore) ; 101(31): e29920, 2022 Aug 05.
Article in English | MEDLINE | ID: covidwho-2051698

ABSTRACT

There is insufficient evidence on SARS-CoV-2 induced neurological effects. Studies on CNS involvement during COVID-19 in children are limited. This study aims to identify and manage the neurological signs and symptoms in COVID-19-infected pediatric patients during follow up and plan future follow-ups. Children diagnosed COVID-19 and hospitalized in the pediatric pandemic services, between March 18, 2020, and June 18, 2021, were included in the study. Children with underlying neurological disease were excluded from the study. Patient data retrieved from hospital files and medical records. Children divided into 2 groups, 1 and 2, based on the presence or absence of neurological findings. A total of 243 children received follow-ups in the pandemic wards, 35 (14.4%) of these patients had neurological findings. Major neurological manifestations were headache (n:17, 7%), seizure (n:4, 1.6%), and anosmia/hyposmia (n:17, 7%). The number of boys (n:13, 37.1%) was smaller than the number of girls (n:22, 62.9%) in Group 1. Group 1 showed higher blood leukocyte, lymphocyte, thrombocyte, AST, LDH, d-dimer values. Anosmia/hyposmia occurred more often in girls, anosmia and headache occurred more often over 9 years of age. Pulmonary and hematologic involvement was more common in children with anosmia and headache. Our study is one of the few studies on neurological involvement in COVID-19 in children. To the best of our knowledge, there is limited data on these subjects in the literature.


Subject(s)
COVID-19 , Nervous System Diseases , Anosmia , COVID-19/complications , Child , Female , Headache/etiology , Humans , Male , Nervous System Diseases/complications , Nervous System Diseases/etiology , SARS-CoV-2 , Seizures/complications
6.
Nat Med ; 28(11): 2269-2270, 2022 Nov.
Article in English | MEDLINE | ID: covidwho-2050429
7.
PLoS One ; 17(9): e0274485, 2022.
Article in English | MEDLINE | ID: covidwho-2043206

ABSTRACT

BACKGROUND: COVID-19 is known to be associated to potentially fatal neurological complications; therefore, it is essential to understand the risk factors for its development and the impact they have on the outcome of COVID-19 patients. AIMS: To determine the risk factors for developing fatal neurological complications and their outcome in hospitalized COVID-19 patients. MATERIAL AND METHODS: Case control study based on hospitalized patients was conducted from July 15th 2021 to December 15th 2021. Cases and controls were COVID-19 confirmed patients with and without severe neurological manifestations. Age, comorbid conditions, vaccination status, Blood Sugar Random (BSR), D-dimers levels, anticoagulation type and dosage were taken as predictors (exposure variables) for developing neurological complications. In the case-only (subgroup) analysis, 28-day mortality were analyzed using the same predictors including admission hypoxemia. Chi square test and regression model were built to calculate OR with 95%CI. RESULTS: Among 383 patients (median age, 56 years [IQR, 24-110]; 49.9% men); 95 had neurological complications (cases) and 288 did not (controls). Development of neurological complications among COVID-19 related hospitalizations was significantly associated with old age >71 yrs. (cases, 23.2%; controls, 13.5%; OR, 3.31; 95% CI, 1.28-8.55), presence of diabetes mellitus (37.9% vs. 24%; OR, 1.9; 95% CI, 1.2-3.1), admission hyperglycemia (BSR 351-600 mg/dl), (29.5% vs. 7.6%; OR, 3.11; 95%CI, 1.54-6.33), raised D-dimer levels 5000-10,000 ng/ml (41% vs. 11.8%; OR, 5.2; 95% CI, 3.02-8.9), prophylactic dose anticoagulation (43.2% vs. 28.1%; OR, 1.9; 95%CI, 1.2-3.1), and unvaccinated status of COVID-19 patients (90.5% vs. 75.6%; OR, 3.01; 95% CI, 1.44-6.25). Neurological complications with COVID-19 were associated with increased likelihood of death or invasive mechanical ventilation by day 28 (86.3% vs. 45.1%; OR, 7.66; 95% CI, 4.08-14.4). In case-only analysis (median age, 56 years [IQR, 27,110]; 50.5% women), 67 (70.5%) had CVE, 21 (22.1%) had Encephalitis, and 7 (7.4%) had GBS as neurological manifestations. 28-day mortality among these patients was strongly associated with a lower likelihood of vaccination. (6.1% cases vs. 30.8% controls; OR, .146; 95%CI, .033- .64), being younger 17-45 yrs. (12.2% vs. 46.2%; OR, .162; 95%CI, .045-.58), having no comorbid condition (19.5% vs. 61.5%; OR, .151; 95%CI, .044- .525), having cerebrovascular events and GBS as type of neurological manifestation (76.8% vs.30.8%; OR, 7.46; 95%CI, 2.06-26.96), (2.4% vs. 38.4%; OR, .04; 95%CI, .007- 0.24) respectively, and presence of hypoxemia at admission (91.5% vs. 15.4%; OR, 58.92; 95%CI, 10.83-320.67). CONCLUSION: Old age, presence of Diabetes Mellitus, unvaccinated status of patients, high BSR at admission, high D-dimers, and prophylactic dose anticoagulation were identifies as increased risk factors for developing serious neurological complications among COVID-19 patients. Neurological problems in COVID-19 patients raised death risk 7.6-fold. The most common neurological complication was cerebrovascular events, followed by encephalitis and GBS. Unvaccinated status, cerebrovascular events, and admission hypoxemia are associated with an increased likelihood of 28-day mortality among these patients.


Subject(s)
COVID-19 , Diabetes Mellitus , Encephalitis , Nervous System Diseases , Aged , Anticoagulants , Blood Glucose , COVID-19/complications , Case-Control Studies , Diabetes Mellitus/epidemiology , Female , Hospitalization , Humans , Hypoxia , Male , Middle Aged , Nervous System Diseases/epidemiology , Nervous System Diseases/etiology , Retrospective Studies , SARS-CoV-2
8.
Life Sci ; 308: 120981, 2022 Nov 01.
Article in English | MEDLINE | ID: covidwho-2042005

ABSTRACT

The emergence of beta-coronavirus SARS-CoV-2 gets entry into its host cells by recognizing angiotensin-converting enzyme 2 (ACE2) and transmembrane serine protease 2 (TMPRESS2) receptors, which are responsible for coronavirus diseases-2019 (COVID-19). Global communities have been affected by COVID-19, especially caused the neurological complications and other critical medical issues. COVID-19 associated complications appear in aged people with underlying neurological states, especially in Parkinson's disease (PD) and Alzheimer's disease (AD). ACE2 receptors abundantly expressed in dopamine neurons may worsen the motor symptoms in PD and upregulates in SARS-CoV-2 infected aged patients' brain with AD. Immune-mediated cytokines released in SARS-CoV-2 infection lead to an indirect immune response that damages the central nervous system. Extreme cytokines release (cytokine storm) occurs due to aberrant immune pathways, and activation in microglial propagates CNS damage in COVID-19 patients. Here, we have explored the pathophysiology, immune responses, and long-term neurological impact on PD and AD patients with COVID-19. It is also a crucial step to understanding COVID-19 pathogenesis to reduce fatal outcomes of neurodegenerative diseases.


Subject(s)
COVID-19 , Nervous System Diseases , Aged , Angiotensin-Converting Enzyme 2 , COVID-19/complications , Cytokines , Humans , Immunity , Nervous System Diseases/etiology , Peptidyl-Dipeptidase A/metabolism , SARS-CoV-2 , Serine Proteases
9.
J Assoc Physicians India ; 70(9): 11-12, 2022 Sep.
Article in English | MEDLINE | ID: covidwho-2025053

ABSTRACT

AIM: There is a need for a better understanding of the relation of various neurological symptoms and complications with manifestations and outcomes of coronavirus disease 2019 (COVID-19). Hence, we planned this study to get an insight into the relation of neurological manifestations and COVID-19. MATERIALS AND METHODS: This was a retrospective study. All patients ≥18 years in age, admitted with reverse transcription-polymerase chain reaction (RT-PCR) confirmed COVID-19 were included in the study. Their clinical records were accessed for collecting demographic and laboratory data. The data collected were analyzed for prevalence and pattern of neurological symptoms at admission and neurological complications developed during hospitalization. It was also analyzed to find the relation of neurological manifestations with duration of hospital stay, requirement of bilevel positive airway pressure (BiPAP) or ventilator, severity of disease, development of neurological complications, and mortality. RESULTS: A total of 440 patients were included. The mean age was 59.28 ± 13.28 years. The most common neurological symptom at presentation was headache while the most common neurological complications were altered sensorium, cerebrovascular stroke, seizure, and encephalitis. Significantly, more patients with neurological complications than those without had severe disease and needed ventilation. Duration of hospitalization was significantly longer (16.26 ± 5.15 vs 12.73 ± 4.89, p = 0.0173) and mortality was also significantly higher (OR 6.59, 95% CI 2.23-19.43; p = 0.0006) in patients with neurological manifestations. CONCLUSION: The presence of neurological manifestations is associated with greater morbidity and mortality in patients with COVID-19 and thus warrants more aggressive treatment. However, a study of association of individual neurological manifestation with severity of COVID-19 will provide a more meaningful insight regarding the approach to the management of such patients.


Subject(s)
COVID-19 , Nervous System Diseases , Aged , COVID-19/complications , COVID-19/epidemiology , Humans , Middle Aged , Nervous System Diseases/epidemiology , Nervous System Diseases/etiology , Pandemics , Retrospective Studies , SARS-CoV-2
10.
J Assoc Physicians India ; 70(9): 11-12, 2022 09.
Article in English | MEDLINE | ID: covidwho-2011783
12.
Int J Environ Res Public Health ; 19(16)2022 08 12.
Article in English | MEDLINE | ID: covidwho-1987770

ABSTRACT

COVID-19 can lead to multiple severe outcomes including neurological and psychological impacts. However, it is challenging to manually scan hundreds of thousands of COVID-19 articles on a regular basis. To update our knowledge, provide sound science to the public, and communicate effectively, it is critical to have an efficient means of following the most current published data. In this study, we developed a language model to search abstracts using the most advanced artificial intelligence (AI) to accurately retrieve articles on COVID-19-associated neurological disorders. We applied this NeuroCORD model to the largest benchmark dataset of COVID-19, CORD-19. We found that the model developed on the training set yielded 94% prediction accuracy on the test set. This result was subsequently verified by two experts in the field. In addition, when applied to 96,000 non-labeled articles that were published after 2020, the NeuroCORD model accurately identified approximately 3% of them to be relevant for the study of COVID-19-associated neurological disorders, while only 0.5% were retrieved using conventional keyword searching. In conclusion, NeuroCORD provides an opportunity to profile neurological disorders resulting from COVID-19 in a rapid and efficient fashion, and its general framework could be used to study other COVID-19-related emerging health issues.


Subject(s)
COVID-19 , Nervous System Diseases , Artificial Intelligence , Humans , Language , Nervous System Diseases/epidemiology , Nervous System Diseases/etiology
13.
Pediatrics ; 150(5)2022 11 01.
Article in English | MEDLINE | ID: covidwho-1987205

ABSTRACT

BACKGROUND: Little is known about the epidemiology and outcomes of neurologic complications associated with coronavirus disease 2019 (COVID-19) in children. METHODS: We performed a cross-sectional study of children 2 months to <18 years of age with COVID-19 discharged from 52 children's hospitals from March 2020 to March 2022. Neurologic complications were defined as encephalopathy, encephalitis, aseptic meningitis, febrile seizure, nonfebrile seizure, brain abscess and bacterial meningitis, Reye's syndrome, and cerebral infarction. We assessed length of stay (LOS), ICU admission, 30 day readmissions, deaths, and hospital costs. We used multivariable logistic regression to identify factors associated with neurologic complications. RESULTS: Of 15 137 children hospitalized with COVID-19, 1060 (7.0%) had a concurrent diagnosis of a neurologic complication. The most frequent neurologic complications were febrile seizures (3.9%), nonfebrile seizures (2.3%), and encephalopathy (2.2%). Hospital LOS, ICU admission, ICU LOS, 30 day readmissions, deaths, and hospital costs were higher in children with neurologic complications compared with those without complications. Factors associated with lower odds of neurologic complications included: younger age (adjusted odds ratio [aOR]: 0.97; 95% confidence interval [CI]: 0.96-0.98), occurrence during delta variant predominant time period (aOR: 0.71; 95% CI: 0.57-0.87), presence of a nonneurologic complex chronic condition (aOR: 0.80; 95% CI: 0.69-0.94). The presence of a neurologic complex chronic condition was associated with higher odds of neurologic complication (aOR 4.14, 95% CI 3.48-4.92). CONCLUSIONS: Neurologic complications are common in children hospitalized with COVID-19 and are associated with worse hospital outcomes. Our findings emphasize the importance of COVID-19 immunization in children, especially in high-risk populations, such as those with neurologic comorbidity.


Subject(s)
Brain Diseases , COVID-19 , Nervous System Diseases , Child , Humans , COVID-19/complications , COVID-19/epidemiology , SARS-CoV-2 , Cross-Sectional Studies , Nervous System Diseases/etiology , Nervous System Diseases/complications , Hospitalization , Chronic Disease , Brain Diseases/complications , Retrospective Studies
16.
Travel Med Infect Dis ; 49: 102414, 2022.
Article in English | MEDLINE | ID: covidwho-1967182

ABSTRACT

Viral infectious diseases have various neurological manifestations, whether they are epidemic or pandemic in nature. Nonspecific encephalopathy is the most common central nervous system (CNS) manifestation. The spectrum of nervous evidence varies for viral pathogens. Some infectious viruses, such as the Ebola virus, exhibit direct neurotropism. Others, such as the Rift Valley fever virus, have the potential for neurotropism. Direct neurotropism is unknown in monkeypox virus, SARS-CoV-2, MERS-CoV, and even smallpox. As seen in the COVID-19, there may be evidence of para-infectious neurological syndrome. There have only been a few reports of neurological diseases caused by monkeypox infection. Future efforts to prevent the spread of infectious disease surges can reduce mortality complications, the therapeutic burden on the health-care system, and prevent further spread. This study describes the clinical and neurological complications of monkeypox infection, particularly encephalitis, as well as the laboratory diagnosis of these cases.


Subject(s)
COVID-19 , Monkeypox , Nervous System Diseases , Orthopoxvirus , Animals , Humans , Monkeypox/complications , Monkeypox/epidemiology , Monkeypox virus , Nervous System Diseases/etiology , SARS-CoV-2
17.
Turk J Pediatr ; 64(3): 571-575, 2022.
Article in English | MEDLINE | ID: covidwho-1964983

ABSTRACT

BACKGROUND: SARS-CoV-2 mostly affects the respiratory system. Some studies have reported neurological disorders associated with SARS-CoV-2. Despite an increase in reported instances, encephalitis caused by COVID-19 infection is still poorly understood. CASE: We reported a rare presentation of SARS-CoV-2 in a 15-year-old patient. He had a fulminant course with encephalitis. He had mild symptoms of a COVID-19 infection five months ago and recovered without any sequel. Despite appropriate treatment, the patient had a devastating course. CONCLUSIONS: This was a severe presentation of SARS-CoV-2 with central nervous system manifestations.


Subject(s)
COVID-19 , Encephalitis , Nervous System Diseases , Adolescent , COVID-19/complications , Child , Encephalitis/complications , Encephalitis/diagnosis , Humans , Male , Nervous System Diseases/etiology , SARS-CoV-2
18.
J Investig Med High Impact Case Rep ; 10: 23247096221111778, 2022.
Article in English | MEDLINE | ID: covidwho-1950962

ABSTRACT

Severe acute respiratory syndrome coronavirus (SARS-CoV-2) infection is commonly associated with neurological complications. Patients with sickle cell disease are at increased risk of developing neurologic complications throughout their lifetimes and often have underlying cardiopulmonary comorbidities that may predispose them to poor outcomes during serious infections. In this case series, we describe 2 patients with sickle cell disease who developed devastating neurologic complications following SARS-CoV-2 infection, which ultimately led to brain edema and death. We highlight the unusual manifestations of coronavirus disease 2019 in patients with sickle cell disease and address the risk of these patients to develop catastrophic neurologic injury due to COVID-19, if not recognized promptly.


Subject(s)
Anemia, Sickle Cell , COVID-19 , Nervous System Diseases , Anemia, Sickle Cell/complications , COVID-19/complications , Comorbidity , Humans , Nervous System Diseases/epidemiology , Nervous System Diseases/etiology , SARS-CoV-2
19.
Brain Nerve ; 74(7): 861-866, 2022 Jul.
Article in Japanese | MEDLINE | ID: covidwho-1954939

ABSTRACT

The new coronavirus SARS-CoV-2 infection (COVID-19) has caused many casualties, mainly respiratory infections. However, it has also caused several neurological disorders including encephalitis/encephalopathy, demyelinating disease, Gullain-Barré sydrome etc. In addition, it has been clarified that movement disorders develop within a few days to weeks after infection. Vaccination for COVID-19 has progressed, but autoimmune neurological complications have also been reported. Although a causal relationship is suspected over time, this paper describes the pathophysiology of movement disorders such as myoclonus, opsoclonus, parkinsonism, and cerebellar ataxia, which are relatively common in COVID-19 infections, and their relevance to the SARS-CoV-2 vaccine.


Subject(s)
COVID-19 , Cerebellar Ataxia , Movement Disorders , Nervous System Diseases , Ataxia , COVID-19/complications , COVID-19 Vaccines , Humans , Movement Disorders/complications , Nervous System Diseases/etiology , SARS-CoV-2
20.
Eur J Immunol ; 52(10): 1561-1571, 2022 Oct.
Article in English | MEDLINE | ID: covidwho-1929796

ABSTRACT

According to the World Health Organization, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has already infected more than 400 million people and caused over 5 million deaths globally. The infection is associated with a wide spectrum of clinical manifestations, ranging from no signs of illness to severe pathological complications that go beyond the typical respiratory symptoms. On this note, new-onset neurological and neuropsychiatric syndromes have been increasingly reported in a large fraction of COVID-19 patients, thus potentially representing a significant public health threat. Although the underlying pathophysiological mechanisms remain elusive, a growing body of evidence suggests that SARS-CoV-2 infection may trigger an autoimmune response, which could potentially contribute to the establishment and/or exacerbation of neurological disorders in COVID-19 patients. Shedding light on this aspect is urgently needed for the development of effective therapeutic intervention. This review highlights the current knowledge of the immune responses occurring in Neuro-COVID patients and discusses potential immune-mediated mechanisms by which SARS-CoV-2 infection may trigger neurological complications.


Subject(s)
COVID-19 , Nervous System Diseases , Autoimmunity , COVID-19/complications , Humans , Nervous System Diseases/etiology , SARS-CoV-2
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